2nd Met ORIF neuralgia/tarsal tunnel

[Katie DoVico]

Hi guys, need a little help here. We have a young athlete who is a goal keeper in soccer and had a Right 2nd metatarsal ORIF, she’s 11 weeks post-op and her scar is healed and closed but is getting intense tingling and pain with light or deep pressure to her proximal scar and to her tarsal tunnel. She’s starting to get ready to touch the ball and the main concern is the neuralgia with kicking with that foot (her dominant foot/punting foot). As right now, slight contact with a light ball creates prolonged neuralgia.
Surgeon has cleared her to play and isn’t concerned.
We’ve been needling up the chain at PPTPs with not a whole lot of change subjectively to her symptoms. We’ve just started minimal scar needling, again without much change.

I know time will help a lot but she doesn’t have a year or so to wait for neurological symptoms to lessen. We are playing with materials to pad this area but haven’t been successful with anything.

Any treatment/padding recommendations to help us out would be much appreciated!!

Thank you!

[Susan Falsone]

Hi Katie!
Sorry for the delay!

Do you think it is just a cutaneous nerve or is it a peripheral nerve? If more peripheral, you could follow the nerve up towards the knee or even needle the dermatome that corresponds where her symptoms are (advanced class thoughts). Also, cupping with a silicone cup may be helpful in scar management, if there is any entrapment there. I will start cupping around 12 weeks if the scar seems stable and like it won’t open. Be mindful.

Those are my initial thoughts. Hoping someone else chimes in!
Sue

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